Abstract
In order to study survivin, matrix metalloproteinases (MMP-2), membranous type 1 matrix metalloproteinase (MT1-MMP), and tissue inhibitor metalloproteinase-2 (TIMP-2) expression immunohistochemically in endometriotic tissues and normal endometrium, our retrospective study considered 194 patients affected by endometriosis and 71 patients with normal endometrium. Tissue microarrays were created from paraffin-embedded blocks; immunohistochemistry was used to assess protein expression. In endometriotic tissues, survivin was expressed at a higher level than in normal endometrium; its glandular expression level was higher in non-ovarian than in ovarian endometriotic tissues and lower in stromal components. Endometrial tissues from women without endometriosis and endometriotic tissues had different matrix metalloproteinase expression profiles. MMP-2 and MT1-MMP correlated with TIMP-2 in endometriotic tissues. Furthermore, in endometriotic tissues, expression of survivin, aurora B kinase, and Ki-67 showed a significant positive correlation, which indicates a role in cellular proliferation that could be closely linked to its anti-apoptotic activity in endometriosis development. Our results imply a role for matrix metalloproteinases in endometriosis invasiveness; correlation of their expression with that of TIMP-2 underscores its possible key regulatory role.



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Abbreviations
- ABK:
-
Aurora B kinase
- APC:
-
Adenomatous polyposis coli
- ASRM:
-
American Society of Reproductive Medicine
- ET:
-
Endometriotic tissue
- IAP:
-
Inhibitor of apoptosis protein
- IQR:
-
Interquartile range
- MMP-2:
-
Matrix metalloproteinase-2
- MMP:
-
Matrix metalloproteinase
- MT1-MMP:
-
Membranous type 1 matrix metalloproteinase
- PR:
-
Progesterone receptor
- TIMP-2:
-
Tissue inhibitor metalloproteinase-2
- TMA:
-
Tissue microarray
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Acknowledgments
We are grateful to Dr. Enrica Stella for her help in this study, Matteo De Luca for the technical assistance in realizing TMA, and to Dr. Serena Bertozzi for her help in preparation of this manuscript. Dr. Giorgio Zaccagna, Dr. Guido Borgna and Dr. Marco Pittino are thanked for their helpful collaboration. This study was financially supported by the University of Udine.
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The authors declare that they have no potential conflicts of interest relevant to this article.
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Ambrogio P. Londero and Angelo Calcagno equally contributed to this work.
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Londero, A.P., Calcagno, A., Grassi, T. et al. Survivin, MMP-2, MT1-MMP, and TIMP-2: their impact on survival, implantation, and proliferation of endometriotic tissues. Virchows Arch 461, 589–599 (2012). https://doi.org/10.1007/s00428-012-1301-4
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DOI: https://doi.org/10.1007/s00428-012-1301-4